复合树脂修复联合氯已定维护治疗在糖尿病患者中应用

目的评价0.12%氯已定对已应用复合树脂充填患牙的糖尿病患者行牙周维护治疗的临床效果。方法选择20例有牙周炎病的糖尿病患者,对其前牙区龋齿进行复合树脂充填治疗后,分为研究组(n=10)和对照组(n=10)。在进行基础牙周治疗之前预防性应用抗生素,在牙周维护治疗阶段给予研究组患者0.12%氯已定15 d,对照组患者不应用氯已定。分别在治疗前和治疗后90 d检测所有患者的菌斑指数、牙龈指数和牙周探诊深度,记录并应用方差分析和Tukey检验对数据进行统计。并对研究组患者进行糖化血红蛋白等血清生化指标的检测,比较治疗前后的差异。结果经过90 d的治疗,研究组患者的菌斑指数、牙龈指数和牙周探诊深度均明显低于对照组,差异有统计学意义(P<0.01)。研究组患者经0.12%氯已定治疗后较治疗前比较,糖化血红蛋白降低,差异有统计学意义(P<0.05);血清总胆红素水平较之前升高(P<0.05);血清磷水平升高(P<0.01);血清钙磷比下降(P<0.01);甘油三酯的水平下降(P<0.05);载脂蛋白A1升高(P<0.01)。结论在牙周维护治疗中,应用0.12%氯已定能够有效改善糖尿病患者已行树脂修复患牙的牙周健康和糖化血红蛋白,此外还可能影响钙、磷、血脂等其他生化指标。

Effect of maintenance therapy with or without the use of chlorhexidine in teeth restored with composite resin in patients with diabetes mellitus

Objective To evaluate the effects of maintenance therapy with or without the use of 0. 12% chlorhexidine in the periodon-tal tissues of patients with diabetes mellitus who had carious lesions restored with composed resin. Methods Twenty patients were se-lected,all of whom had diabetes mellitus in addition to carious cervical lesions in previously treated teeth. All the patients were diveded into two groups(n = 10 in each). For all patients,antibiotic prophylaxis was performed before the basic periodontal treatment. The ex-perimental group received supplemental periodontal therapy with the use of 0. 12% chlorhexidine for 15 days,examiner determined the following for each patient:Silness and Loe plaque index,Silness and Loe gingival index,and probing depth,clinical examinations were performed at 0 and 90 days. Moreover,the HbAlc,and the other serum biochemical markers of the experimental group were tested at baseline and 90 days after periodontal therapy. The data were analyzed and assessed by means of ANOVA and Tukey's test. Results After 90 days,improvement in plaque and gingival indices and probing depth were noticed among patients in the group that received 0. 12% chlorhexidine(P < 0. 01). The HbAlc also decreased statistically(P < 0. 05);Other serum biochemical markers changed sig-nificantly including serum total bilirubin increased(P < 0. 05),serum phosphor inereased(P < 0. 01),calcium-phosphorus ratio de-creased(P < 0. 01),triglyceride decreased(P < 0. 05),Apo A1 increased(P < 0. 01). Conclusion Maintenance therapy associated with the use of 0. 12% chlorhexidine could be effective for the HbAlc and the health of periodontal tissues of teeth restored with com-posite resin in patients with diabetes mellitus. In addition,this therapy could also intervene serum calcium,serum phosphorus,and the me-tabolism of lipid.